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Not every forgotten word deserves a multiple sclerosis label.

That thought crystallized for me during a recent virtual meeting of an MS patient advisory panel. As we introduced ourselves, one member paused mid-sentence when she lost her train of thought, then quickly apologized.

“Sorry. Brain fart.”

I felt an immediate sense of relief.

I had braced myself for what so often follows moments such as that in the MS community. That automatic pivot to cognitive fog, or “cog fog.” But she immediately cited a non-MS reason — brain fart — and no one corrected her. No one reframed it.

And in that small, offhand moment, something clicked for me.

Somewhere along the way, many of us living with MS have grown quick to give the disease credit it hasn’t earned:

• A missed word? Cog fog.
• A forgotten task? Cog fog. 
• A moment of confusion? Cog fog.

I regularly have found myself silently pushing back against that reflex. Not everything needs an MS label. Not every mental hiccup is a symptom. Sometimes, forgetfulness is simply part of being human.

Recognizing that difference matters.

Credit where it is due 

Some may see this as me living in denial, as if I’m minimizing what MS is doing to me. I see it differently. I am not denying MS. Rather, I am refusing to let it take credit for every challenge I face.

Everyone knows what a “brain fart” is. It’s walking into a room and forgetting why you’re there. It’s losing a word mid-sentence or blanking on a familiar name, only for it to return moments later. We laugh it off. Apologize. Maybe blame a long day or too little coffee. 

After my MS diagnosis, I resisted labeling every forgetful moment as neurological, and that distinction matters.

When everything becomes cog fog, the term loses its meaning. And when that happens, it becomes harder to explain what cog fog in MS actually feels like when it’s real, especially when the forgetful moments become disruptive and impossible to ignore.

Cog fog versus brain fart

True cog fog announces itself differently.

One of my clearest experiences came during a conversation with my wife, Jennifer, about a recent church council meeting. I understood the topic (I am president of the church council, after all) and knew the point I wanted to make. I could feel the thought forming.

But when it came time to speak, nothing arrived.

No words. No sentence. No divine intervention. Just a blank space where language should have been.

I smiled. Nodded. Bought time. Let the conversation continue while my brain scrambled behind the scenes, searching for something to hold on to.

That wasn’t a brain fart.

A brain fart is forgetting a word. Cognitive fog is losing the sentence. 

With a brain fart, there’s confidence the thought will return. With cog fog, there is no such guarantee. Effort doesn’t always help, concentration doesn’t unlock the door, and caring deeply doesn’t make the words reappear.

That lack of control is the difference.

Being intentional in casting blame

It’s also why cognitive fog carries more than cognitive weight. It brings self-doubt and the fear of being misunderstood or misjudged. It quietly reshapes how we show up in conversations and relationships.

That’s why I am more intentional about when I blame MS, not because cognitive fog isn’t real, but because it is. When cog fog shows up, it deserves to be named accurately and not diluted by every ordinary lapse that happens to everyone, whether or not they have MS.

Forgetfulness is human. Cognitive fog is neurological. 

They may look alike, but they carry very different weight. One comes and goes. The other reshapes how we connect with others and how we trust ourselves.

Giving MS credit only when it’s truly earned has helped me show myself a little more grace and recognize the moments that simply are part of being human.